Water and electrolyte metabolism of the micropremie

There are five problem schemas presented in this article that indicate pote ntial contradictions in therapeutic goals: (1) shock and edema presenting u pon premature birth; (2) the hyperosmolar state, problematic in patients le ss than 750 g birth weight; (3) the respiratory distress syndrome and respi ratory failure, often complicated by patent ductus arteriosus; (4) bronchop ulmonary dysplasia, resulting from prematurity and mechanical ventilation; and (5) late onset of hyponatremia, sometimes accompanied by growth failure in the recovering premature. These five problems considered together compr ise a developmental continuum of illness and recovery, where appropriate fl uid management has recently been demonstrated to benefit outcomes greatly. Clinicians over the past decade have encountered all of the fluid and elect rolyte nightmares. Although there are many different formulations for treat ing each of these scenarios, recommending one approach for all patients is likely to be incorrect much of the time.